DIABETES PREVALANCE

Approximately 18.2 million people, or 6.3% of the population, have diabetes, and another 41 million people have pre-diabetes. Of the 18.2 million people with diabetes, nearly one third (5.2 million people) remain undiagnosed. Undiagnosed diabetes is a concern because it is known that complications of diabetes often begin long before diagnosis, and because early treatment can decrease morbidity and mortality associated with diabetes.

TYPE 1 DIABETES

Previously referred to as "juvenile diabetes" or "insulin-dependent diabetes mellitus," is characterized by autoimmune destruction of pancreatic beta cells, or insulin deficiency and the requirement of insulin for survival. Type 1 diabetes affects 5-10% of people with diabetes. Onset is generally before age 30 years.

TYPE 2 DIABETES

Is the most prevalent form of diabetes. It was previously referred to as "adult onset" or "non-insulin-dependent" diabetes. In type 2 diabetes, initial insulin resistance generally predates the development of hyperglycemia. Type 2 affects 16 million to 17 million people in the United States and accounts for 90-95% of cases of diabetes

PRE-DIABETES

Is a blood glucose level greater than normal but less than those required for the diagnosis of diabetes. It is strongly associated with an increased incidence of diabetes and may also increase the risk of cardiovascular disease. This intermediate stage between normal blood glucose and diabetes is now referred to as "pre-diabetes." Individuals with pre-diabetes include those with a fasting blood glucose value of 100-125 mg/dl.

GESTATIONAL DIABETES

is defined as glucose intolerance that is first diagnosed during pregnancy. Approximately 7% of all pregnancies are complicated with GDM.

DIABETES PREVENTION

Lifestyle changes, such as increased energy intake and decreased physical activity, promote obesity, which in turn is a risk factor for type 2 diabetes. Genetic susceptibility also appears to plan a strong role in the occurrence of type 2 diabetes in certain populations. Lifestyle modification, including medical nutrition therapy, is the cornerstone of type 2 diabetes prevention and treatment.Recent research indicates that diabetes can be prevented or delayed in these high-risk individuals and that therapeutic lifestyle change is an essential component of these preventive strategies.

CERTIFIED DIABETES EDUCATOR

Certification is a voluntary testing program used to assess qualified health professionals' knowledge in diabetes education. The CDE credential demonstrates that the health care professional possesses distinct and specialized knowledge, thereby promoting quality care for persons with diabetes. Specific criteria must be met to sit for the CDE examination.

REGISTERED DIETITIANS

Demonstrate their competence to provide diabetes care based on their education, training, and competency maintained through the RD credential, and assume responsibility for maintaining skills and competencies specific to diabetes care. Dietetics professionals who choose to develop expertise in diabetes care can also demonstrate this specialized knowledge by obtaining additional certification beyond the RD credential.

REFERRAL TO A REGISTERED DIETITIAN

For individuals newly diagnosed with Type 1 or Type 2 diabetes, the referral should occur within the first month after diagnosis. Initially, a series of two to three visits is recommended, totaling 2.5 to 3 hours. For follow-up care additional visits are recommended if further education is needed, medications or insulin has been added to therapy, or regular contact is needed for weight management. Ongoing self-management training is recommended at 6-month to 1-year intervals.

LINKS:

American Diabetes Association
National Diabetes Education Program
National Diabetes Information Clearinghouse
Diabetes Exercise & Sports Association
Juvenile Diabetes Research Foundation International